Postnatal depression in men

How postnatal depression can affect fathers

There’s a widespread belief that postnatal depression (PND) is experienced only by women, but research and anecdotal evidence shows postnatal depression in men too. Men suffering from PND need help and support to recover.

Postnatal depression in men: facts

Around 3-10% of men will experience depression during the postnatal period. Many people think that men experience paternal postnatal depression (PND) as a result of, or in conjunction with, their partner’s depression, but men can experience this independently from their partners. Although PND in mothers is the strongest predictor of partners having it too, it doesn’t always happen this way.

Depression in new fathers has been found to begin before the birth of their child, with minimal recovery by the end of the first year. There’s also evidence to suggest that men’s depression increases between six weeks and six months after childbirth. For example, one study found that 3 out of 10 men were depressed at six weeks, and that their depression got worse during the next six months.

There is also growing evidence that anxiety might be a problem for some men during the antenatal and postnatal period.

New fathers don’t access the sort of services that new mothers do. They don’t tend to see their doctor, child and family health nurse or midwife, which is where problems are often picked up in women.

As with women, it’s important that postnatal depression in men is recognised and treated early and effectively. This will help avoid long-term effects on the father’s mental health and his relationships with his partner, children, family and friends.

Contributing factors to postnatal depression in men

As with all forms of depression, there’s a range of physical, social and emotional factors that contribute to the development of postnatal depression in men.

Some factors that contribute to paternal PND are the same as for maternal PND. Factors common to men and women can include:

a lack of social and emotional support

personality characteristics

stress and changes in relationships (particularly the couple relationship)

a lack of sleep

loss and grief issues

difficulty adjusting to the changes associated with the transition to parenthood

unmet antenatal expectations

a negative or traumatic birth experience (the way men experience childbirth might have some influence on their subsequent emotional wellbeing).

Other factors are specific to men. These can include:

the impact of changing social roles for fathers in the family

attitudes towards fatherhood and masculinity – men are less likely to talk about how they feel, and it’s important to them that they seem like they’re coping

a change in family dynamics – some men might feel excluded from the parenting role or from the relationship with their partner, which can result in resentment towards the baby

worries about extra responsibilities, financial burdens and managing the stress of work

pregnancy, particularly early on – this appears to be the most stressful period for a man in the transition to fatherhood. This might be because of the changes in his partner’s body, how supported and included he feels, concern about the impending changes to his life, and feelings of uncertainty about his role in caring for his partner

a lack of opportunities to bond with the baby until after birth, unlike mothers, who can bond during the pregnancy.

Some men experience PND in conjunction with their partner’s depression, and studies have shown that maternal and paternal depression are highly correlated.

Men report that their partner’s PND causes disruption in their lives and their relationship with their partner. Male partners can experience fear, confusion and a sense of helplessness that they’re unable to help the baby’s mother overcome her depression. They can also feel a sense of disconnection and alienation from their partner.

Men can experience PND as overwhelming, isolating, stigmatising and frustrating.

As a man, many of the stresses and problems you experience during the PND period might not be about your relationship at all. They’re actually consequences of the illness. Although it can be very hard, it is possible to help your partner and maintain your own wellbeing through this period.

Risk factors for postnatal depression in men

Some of the known risk factors associated with postnatal depression in men include:

a man’s partner experiencing PND

a previous history of depression or anxiety

relationship problems

low self-esteem

feelings of incompetence in the parenting role

first-time fatherhood

infant irritability.

Some men mightn’t be able to identify any PND risk factors in their lives, but they still develop PND. Paternal PND can affect men of all ages, personality types and economic status.

Symptoms of postnatal depression in men

Symptoms of postnatal depression in men include:

tiredness, headaches and pain

irritability, anxiety and anger

loss of libido

changes in appetite

feelings of being overwhelmed, out of control and unable to cope

a tendency to take risks

changes to sleep patterns, especially a lack of sleep

feelings of isolation and disconnection from partner, friends or family

withdrawal from intimate relationships and from family, friends and community life

increased hours of work as a part of the withdrawal from family

increased use of alcohol and other drugs instead of seeking treatment for depression and anxiety.

Fathers’ experiences of postnatal depression

Some fathers describe their experience of postnatal depression as feeling trapped, almost like pacing in a cage. They feel extremely alone in their situation and don’t know how to get out.

Other fathers experience PND as being overcome with anger and rage. They feel angry at their partners, children or other family members. They can feel confused about their feelings and are often shocked at their own behaviour.

Some are overwhelmed by feelings of hopelessness and helplessness. They feel their lives and sense of self might never return to normal.

Some fathers feel disappointed by their experience of fatherhood. They feel they’ve failed in their role as a father, and that they’ve let themselves, their children or partners down. They might feel that fatherhood hasn’t been what they expected and feel let down themselves.

Effects on child development

Postnatal depression in men can have specific and long-lasting negative effects on children’s development if the PND symptoms remain untreated over a long period of time.

Research has shown that depression in fathers in the postnatal period is associated with poorer social and emotional behavioural outcomes in children at age three – particularly in boys – even when the mother doesn’t have PND.

Men with depression are also less likely to read to or play with their children.

Postnatal depression in men: impact in the workplace

Postnatal depression can negatively affect nearly every area of a man’s life including his capacity to work.

Research shows that perinatal depression has a huge impact on Australian workplaces through reduced productivity, increased absenteeism and increased costs. Lost productivity alone conservatively cost Australian businesses more than $310 million in 2012.

Supporting a partner with PND can also affect a father’s capacity to work. It can be more difficult to leave to go to work, and fathers might find it difficult to maintain concentration or be disrupted by frequent calls to come home.

It’s important that fathers experiencing PND or supporting a partner through it receive the care and support they need during this time. Parents might need to seek additional flexibility and assistance from their workplaces.

Seeking help for postnatal depression in men

If you’re a man experiencing postnatal depression, some strategies and treatment options are available:

Ask your doctor for a referral to a psychologist or psychiatrist who specialises in PND – you might be eligible for Medicare rebates.

Seek extra support – go along to your baby’s next child and family health nurse appointment and discuss your situation with the nurse. She might be aware of other local services.

Seek support groups. It’s very common for women experiencing PND to attend support groups, but there are very few groups established for men. These groups can be immensely beneficial, so it might be worth contacting your community health care centre.

Talk with your doctor about antidepressants. You might benefit from antidepressant medication, especially if your wellbeing and your family’s wellbeing is at risk. Talk with your doctor about the possibilities.

Seek emotional and practical support from your partner, family and friends, work colleagues, and anyone who is willing to help. The nature of depression will probably mean you feel isolated and alone. Asking for help, talking things through, and even just spending more time with the people you love – these things can help you reconnect with your positive feelings again.

Remember to be kind to yourself.

Keep in mind that there is help available and
you’re not alone. With the appropriate treatment, you can begin to feel
better and start to enjoy being a new father.

VideoHow fathers’ roles are changing

One of the factors specific to men’s experience of PND is the changing roles of modern fathers.

In this short video, men talk about how the experience of being a dad has changed from their fathers’ generation. They say that although being a modern dad brings lots of magical moments with their children, there are also lots of pressures. For example, dads often need to balance work and family, and they sometimes feel they have to be both protectors and nurturers. The dads and experts in this video agree that it’s important for men to talk about how they want to be a dad.

Bielawska-Batorowicz, E., & Kossakowska-Petrycka, K. (2006). Depressive mood in men after the birth of their offspring in relation to a partner’s depression, social support, fathers’ personality and prenatal expectations. Journal of Reproductive and Infant Psychology, 24, 21-29.

Condon, J.T., Boyce, P., & Corkindale, C.J. (2004). The first time fathers study: A prospective study of the mental health and wellbeing of men during the transition to parenthood. Australian and New Zealand Journal of Psychiatry, 38, 56-64.